House committee hears EMS office update and lays over package of bills on rural ambulance funding, workforce and rates

Chair Backer convened the House Health Finance and Policy Committee on Monday, Feb. 24, and the panel received an update from Director Ferguson of the newly created Minnesota Office of Emergency Medical Services and laid over several EMS-related bills for possible inclusion in the house omnibus package.

The committee heard from Director Ferguson, director of the Office of Emergency Medical Services, who described the office’s transition from the former EMS regulatory board into a state agency effective Jan. 1 and outlined priorities including a new state EMS strategic plan, workforce supports and two small rule-making projects. “Really to date, my goal, as the director for the office has been focusing on minimizing disruption and ensuring a smooth transition and trying to build upon the efficient quality service that had really strengthened in the EMS RB over the course of the last 2 to 3 years,” Ferguson said.

The update identified recent funding and pilots enacted in last session’s EMS omnibus bill: a $24,000,000 aid program distributed on Dec. 26 under a formula that apportioned 40% by square mileage, 40% by response volume with a sliding scale to favor smaller services, and 20% as an across-the-board allocation; and a $6,000,000 alternate EMS response pilot (the “sprint medic” pilot) split between Otter Tail and Grant counties and St. Louis County. Ferguson said the Otter Tail project has an executed GRAMA contract and is preparing to begin operations; the St. Louis County application remained pending at the time of the hearing. He told the committee that the aid funds must be spent or encumbered by Dec. 30, 2025, and that a report back to the legislature is expected in calendar year 2026.

Why it matters: Committee members and testifiers said rural ambulance services are increasingly operating at a loss as payer mix shifts toward Medicare and Medicaid and volunteer staffing declines. Committee members framed the bills on the agenda as a coordinated response to sustain coverage across Greater Minnesota and to increase recruitment into the EMS pipeline.

Bills and testimony

House File 337 (Zalesnikar) — Greater Minnesota ambulance sustainability: Representative Zalesnikar moved House File 337 and offered an A2 author amendment; the amendment was adopted by voice vote and the bill as amended was laid over for possible inclusion in the omnibus. The bill would create a grant program administered by the Office of Emergency Medical Services to identify and support ambulance services with operating deficits; the measure as discussed would exclude the 7-county metro and large regional centers (Duluth, Mankato, Rochester, St. Cloud) from eligibility.

Testimony: Eric Simonson of the Coalition of Greater Minnesota Cities told the committee the bill “provides a clean formula using data provided to the state that distributes grant dollars only where they are needed” and cited 2023 reporting showing non-metro services had deficits totaling more than $30 million under the bill’s formula. Mike Warner, fire chief for Red Wing, said his service’s payer mix was 72% government-funded and that government reimbursement covered only a fraction of actual costs. Tim Meyer of Sanford Ambulance and Kevin Lee of North Memorial also urged support, describing staffing shortages, rising labor costs and the risk that smaller services will transfer ownership to larger providers absent sustained revenue.

House File 36 (Hewitt) — Nonemergent/special medical transport: Representative Hewitt presented House File 36, a proposal to raise base and mileage rates for nonemergency medical transport (transport of patients who are not emergent but medically vulnerable). The bill was laid over for possible inclusion. Hewitt said nonemergency medical transport affects hospital throughput and long waits for inpatient beds and that higher rates are needed to sustain providers who move vulnerable patients between facilities, to dialysis and to clinics. The author acknowledged the bill needs further work and stakeholder input.

House File 93 (Backer) — Earn-while-you-learn EMT grant program: Representative Backer moved House File 93 and an intent to lay the bill over for inclusion. The bill would create an “earn while you learn” grant program administered by the Office of Emergency Medical Services to employ and pay trainees while they complete EMT training, with the goal of adding 100 entry-level positions per year. Mayo Clinic Ambulance’s pilot was presented as evidence of feasibility. Tyler Boss, an EMT who completed an earn-while-you-learn program, testified: “Being able to earn a full time wage while training wasn't just helpful, it was essential.” Dan Anger, director of education and training for Mayo Clinic Ambulance, said Mayo recruited eight trainees out of more than 40 applicants; all eight passed national registry exams and accepted full-time positions.

The author said the bill included an appropriation (presented in committee as $750,000 in FY2026 and $750,000 in FY2027) and that the committee should consider whether statutory hourly pay levels are appropriate for an ongoing program.

House File 94 (Backer) — Volunteer training reimbursement: Representative Backer offered an A1 amendment that adjusted eligibility by annual call volume (lowering the maximum from 5,000 calls per year to 4,000) and the committee adopted the amendment by voice vote. House File 94 (as amended) would expand reimbursement for initial and continuing education for volunteer emergency responders, add emergency medical responder (EMR) training, and increase the training fund (the bill would add $100,000 to the existing $361,000 appropriation). Buck McAlpin of the Minnesota Ambulance Association said the fund has been a useful tool for volunteer and rural services and that higher-ed paramedic scholarship funds are producing new paramedics for the workforce.

House File 715 (Backer) — Medicaid/Medicare reimbursement increase: Representative Backer offered House File 715 with an A1 amendment; the amendment was adopted by voice vote and the bill was laid over as amended. The proposal would increase reimbursement rates (the author said the amendment provides a 10% increase). Buck McAlpin told members the EMS sector has not seen an increase since 2016 and that rising payer pressure in rural areas—where 80% or more of calls may be Medicare/Medicaid—has created a chronic shortfall. Several members cautioned that a modest percentage increase will not fully close readiness or staffing gaps but could be part of a broader package that includes targeted grants for low-volume services.

Votes at a glance (committee action) - Approval of committee minutes: motion to approve moved by Representative Ryer; voice vote — approved. - House File 337 (A2 amendment): amendment adopted by voice vote; House File 337 as amended laid over for possible inclusion. - House File 36: laid over for possible inclusion. - House File 93: laid over for possible inclusion. - House File 94 (A1 amendment): amendment adopted by voice vote; House File 94 as amended laid over for possible inclusion. - House File 715 (A1 amendment): amendment adopted by voice vote; House File 715 as amended laid over for possible inclusion.

Discussion and next steps

Committee members repeatedly emphasized the need to pair immediate relief with long-term reforms: representatives said the $24 million emergency aid enacted last year helped but did not solve systemic shortfalls and urged the Office of EMS and the newly formed advisory groups to continue evaluating pilots, data collection and potential funding sources. Director Ferguson said the office will work on workforce data collection (including workplace violence reporting), update ambulance vehicle construction standards, and advise on medication options for basic life support services.

Representative Hewitt and others said local control and accountability are priorities when state funds are distributed; testifiers and members discussed the tradeoffs between statewide rate increases and targeted grant programs for low-volume services.

The committee laid the package over for possible inclusion in the omnibus bill and directed staff and the Office of EMS to supply members with data on fund distribution and service volumes.

Ending: The committee adjourned after laying the EMS bills over and indicated further hearings and negotiation would follow as the legislature’s budget process proceeds.